1. Expert Q&A: Protecting a person with dementia from financial abuse - Weds 26 June, 3:30-4:30 pm

    Financial abuse can have serious consequences for a person with dementia. Find out how to protect a person with dementia from financial abuse.

    Sam, our Knowledge Officer (Legal and Welfare Rights) is our expert on this topic. She will be here to answer your questions on Wednesday 26 June between 3:30 - 4:30 pm.

    You can either post questions >here< or email them to us at talkingpoint@alzheimers.org.uk and we'll answer as many as we can on the day.

  1. ferndale

    ferndale Registered User

    Oct 16, 2007
    1
    Leicestershire
    My mum has alzheimers. she has refused to eat or drink virtually anything for 4 weeks. She is currently in hosiptal but they want to send her home even though she still has a urinary infection, can not go to the loo properly, cant walk unaided and will not eat or drink. 4 weeks ago she was walking in the country park with us, eating pub meals and enjoying her life in the residential home. Now she hardly knows where she is. Is there anything we can ask the hospital to try to get her eating and drinking again? They say it is a matter for the residential home to work on but the home tell us it is not something they can do. She is back in the hospital only 6 days after being sent home following admission for the same problems as now - mainly dehydration and infection in the water. Interested in any ideas. Thanks
     
  2. Grannie G

    Grannie G Volunteer Moderator

    Apr 3, 2006
    68,672
    Kent
    OH dear, this must be terrible for you. All I can say is that urine infections, [Urinary Tract Infections]cause very severe symptoms, symptoms far more severe than you would imagine.

    The infection could be responsible for all your mother`s symptoms and the hospital sounds quite unsympathetic. I would ask them to help clear your mother of infection before she is discharged, or at least see some improvement in her condition.
     
  3. Skye

    Skye Registered User

    Aug 29, 2006
    17,000
    SW Scotland
    Hi ferndale, welcome to TP

    UTIs have a devastating efffect on people with dementia. My husband has just recovered from one, and the effect was very similar to your mum's.

    Two months ago he was at home, enjoying regular walks, days out, etc. He had over a month in hospital, and is now in a nursing home.

    He lost mobility and balance, his confusion increased, and he became aggressive. He is now in an EMI unit, because he needs specialist care.

    I would never have believed that an infection could have caused such deterioration, so quickly.

    The first thing to do is ask to see the ward doctor, and demand that they do a urine culture. They try to rely on blood tests, but that's not sufficient for a severe infection. Generic antibiotics do not work, the specific infection has to be identified, and the appropriate antibiotic prescribed.

    Secondly, you ned to insist that your mum is not discharged until the infection has cleared. Your social worker should help with this. A residential home is not equipped to deal with major infections.

    I'm sorry, I'm giving you more battles to fight, and I'm sure that's the last thing you need at the moment. Contact you Sw as soon as possible, hopefully he/she will fight for you.

    Good luck,
     
  4. Cate

    Cate Registered User

    Jul 2, 2006
    1,370
    Newport, Gwent
    Hi Ferndale

    I totally agree, I would insist that mum is not discharged until the UTI has been identified and treated. Its no wonder that mum is so very poorly, and shame on them for wanting to send her home with this.

    I hope you manage to get a satisfactory outcome.
     
  5. ellie 123

    ellie 123 Registered User

    May 25, 2006
    91
    Can I come in on this and ask a really stupid question?

    You are all advising that the hospital should clear the urine infection but in my case mum is being discharged with an infection because the hospital cannot stop the cycle of infection/c.diff. I have never been happy with this due to the effects the infection causes, but have been told there is no more medically that can be done.

    How do we know what can be done or not? Now I'm beginning to wonder should I force them to do more, or is true that they can do more. It sometimes seems to me that our medical ignorance works in the professionals' favour.

    Confused.

    ellie
     
  6. jenniferpa

    jenniferpa Volunteer Moderator

    Jun 27, 2006
    39,417
    Hi Ellie

    I think C. difficile is a different situation. That infects the intestines and is extremely difficult to irradicate, particularly in a hospital setting, since reinfection is fairly common. Have they tried the appropriate antibiotic which I think is vancomycin? This is expensive though, and they may be dodging it.

    A UTI on the other hand, if properly cultured to identify the bacteria, should be possible to treat with reasonable inexpensive meds Unfortunately, there seems to be an unwillingness to do these cultures, although I have no idea why - it seems a no brainer to me.
     
  7. ellie 123

    ellie 123 Registered User

    May 25, 2006
    91
    Hi Jennifer

    Yes mum has had vancomycin - they didn't give it to her immediately, not until her second c. diff. It works well but then each time they treated the urine infection, back came the c diff, more vancomycin an all clear, then back to the UTI.

    I only ask because obviously anything that makes the dementia worse (as in UTI) makes you feel as if you're up against if you know what I mean. You sort of want as much of the secondary illnesses cleared up, if poss, so that she's as good as she can be under the circumstances.

    Sorry, I'm not being too clear, my mind feels all clogged up been stuck in bed for 48 hours with a really awful cold virus and worrying how I'll cope if this happens when mum's living with me.

    Sorry Jen, I'll go now before I keep babbling on!

    Love ellie
     
  8. Jilly88

    Jilly88 Registered User

    Aug 11, 2006
    39
    Margate, Kent.
    Uti

    Can I ask what brings on these infections and how it can be avoided? What are the symptoms? What is the cure?
    Thanks a lot.
    Jilly
     
  9. ellie 123

    ellie 123 Registered User

    May 25, 2006
    91
    Hi Jilly

    I don't know the medical explanation, in the elderly is has a lot to do with hygiene (as in how they wipe themselves after using the toilet.

    Mum and I seem to be prone to it. In the weeks before mum went into hospital, she seemed to constantly have one. No sooner had the antibiotics worked, then another infection started. I always knew because she started to have hallucinations which went away with treatment. But I'm often walking around with one and not even aware of it. It's only if the GP does a stick test that we know. Maybe that's why I'm so mad - it's the infection, honest, not me!!!!

    ellie
     
  10. Nebiroth

    Nebiroth Registered User

    Aug 20, 2006
    3,518
    They will always be reluctant to use Vancomycin, this is because it is the "antibiotic of last resort". It is the one of the few remaining drugs that the resistant strains are still sensitive to, and if it is used too much then resistance will develop to this antibiotic as well.

    Many of the resistant strains developed because antibiotics such as penicillin were overprescribed and overused, often when they were not needed, or inappropriately.

    They are extremely wary of vancomycin going the same way, because at the moment there is very little left in the "armoury" after it.

    Expense is not the only consideration.

    If someone is getting persistent and recurrent UTI's, then this is an ideal situation for resistant strains to develop.

    It sounds harsh but this must be considered.
     
  11. Nebiroth

    Nebiroth Registered User

    Aug 20, 2006
    3,518
    #11 Nebiroth, Oct 17, 2007
    Last edited: Oct 17, 2007
    UTI is an infection of the urinary tract. It happens when bacteria get into the urine and multiply. The most common one is infection in the bladder, which is also called cystitis. You can also get infection in the kidneys, which is more serious, and is called pyelonephritis.

    Because of their "plumbing arrangements" women are much more likely to get UTI's than men, because the route to the bladder is much shorter.

    Anyone can get them. Poor hygiene technique can contribute (always wipe up, not down, to avoid contamination with faecal matter). Staying generally healthy, if you get run down, stressed etc, you're more likely to get it. Drinking cranberry juice every day (or cranberry extract pills) can help, it's thought that a type of tannin in it stops bacteria adhering to the walls of the bladder. Drinking plenty of fluids will help keep things flushed clear. Resisting an urge to urinate is unhealthy because stale urine is left in the bladder.

    The symptoms are usually frequent urination, which may be painful or have a burning sensation, having to get up in the night to urinate, pain in the urethra, cloudy/foul smelling urine, fever. But some people have a UTI and have no symptoms at all. In people with dementia, it will make the dementia symptoms worse whether or not the physical symptoms show.

    The kidney infection has the same, but will be accompanied by things like high fever, chills, abdominal pain, night sweats and fatigue (you will know you're seriously ill!).

    It is usually diagnosed by stick-testing a urine sample. The treatment is usually an anti-bacterial drug or antibiotic.

    As ever, it's important to see your GP right away, not least because other things have similar symptoms.

    Being male I suprised my GP by getting a UTI a year ago, the main symptom was having to go to the loo about every half-hour. Cleared up quickly, though. In men trouble with urination is often an indicator of prostate problems, so whilst women have UTI's to contend with at least they don't have to think about that one :rolleyes:

    I couldn't find a convenient NHS page, although I'm sure there is one, but there's a factsheet on Bupa

    http://hcd2.bupa.co.uk/fact_sheets/Mosby_factsheets/Urinary_tract_infection.html
     
  12. chip

    chip Registered User

    Jul 19, 2005
    400
    Scotland
    My husband was falling a lot so the hospital done a UTI test was told no sign of infection. I was giving him his coffee the other day at times he would swallow no problem but would also choke or clench his teeth around the mug. He is constantly jerking as well. I always get told its deterioration of his illness - i get the impression as this awful illness is ether a rapid or slow deterorating illness and they can't do anything to stop it, it is down to cost so its put on to Nursing homes or family.
     
  13. Mameeskye

    Mameeskye Registered User

    Aug 9, 2007
    1,669
    NZ
    Hi Ferndale

    Your post sounds all too familiar to me. My Mum ahs had several UTIs and they hit her hard. She ahs vascular dementia and it is possible that the HBP which lead to this has also cuased over the years some kidney damage which has predisposed her to the infections.

    the nursing staff have advised me that Gps tend not to prescribe for asymptomatic infection these days, preferring the body to clear it by itself because of the problems that resistance to antibiotics is now causing. However in a dementia patient there are symptoms, jsut not those that the GP would expect.

    We have discovered though with Mum that it takes her a while to get over antibiotic treatment in iteself. It can be difficult to get her to drink which compounds the symptoms.

    We now check first of all if she is just too weak to drink and we use a syringe to try. If this goes down easily we keep it up (which it always has done up to now as Mum will suck at the syringe even if too weak to drink) This can be intensive and requires fluid to be offered at very frequent intervals. If you want to think about how a hangover feels that is what dehydration is like. The problem is that with the various "protections " in place staff do not like to use a syringe for fear of being accused of "force feeding".

    The we would move on to rich yoghurts, not the diet stuff...the full fat stuff, live preferably as it helps the bacteria in the gut right themselves after infection.

    It takes time and I would suggest that a good Nursing home is going to give it their best shot...a hospital in my experience doesn't even attempt encouragement to eat and it has to be done frequently and with small amounts and they do not have the manpower.

    Also helpful are the high calorie milkshakes, some of which can give almost a days calories in a couple of drinks. You can also add calories when feeding the yoghurt with procal.

    My Mum wanted to get better, she made that clear so this is why we did this. It takes time but all of a sudden Mum suddenly reappeared, having been written off as dying by her GP. She also recovered to the extent she had been before the infection for 6 months before another infection combined with TIA took her down further.

    ((((Hugs))))

    Mameeskye
     
  14. Jilly88

    Jilly88 Registered User

    Aug 11, 2006
    39
    Margate, Kent.
    Thank you all of you that helped me understand these UTIs. It sounds awful, but I'm more aware of what to look out for now.
    Thanks again,
    Love
    Jilly
     
  15. Skye

    Skye Registered User

    Aug 29, 2006
    17,000
    SW Scotland
    In John's case, the first signs were extreme agitation and aggression, in someone who had never before been aggressive. There were no signs of infection. At this stage he was prescribed a mild sedative.

    The agitation got worse, and he began to fall and be unable to get up. I was having to call paramedics out to lift him. By this time, thanks to TP, I suspected UTI and rang GP, who prescribed antibiotic. I also got an emergency support package. John continued to deteriorate, the antibiotics had no effect. It was only at this stage that his urine began to smell. He had a high temperature, was shaking constantly, and the carer thought he was going to have a siezure. At this stage he was admitted to hospital. He has recovered from the UTI, but not from the peripheral damage to the brain.

    Scary? Yes, it's devastating.
     
  16. Helena

    Helena Registered User

    May 24, 2006
    715
    Alzheimers causes a very low immune system and hence patients will be far more prone to infections
    Once CDiff or any other infection is deep seated its almost impossible for Antibiotics to tackle it .............Pneumonia used to be a Dementia patients "friend " now it tends to be C Diff

    Often you will find the patient also has a rectal prolapse and thus the cycle of infection cant be stopped

    As my Mothers consultant told me ........strokes and dementia make for a vulnerable brain this along with the general frailty of age makes the patient infinitely more suseptible

    Maybe we all need to look at things differently no matter how hard it is and how much we do not want to loose them
     
  17. Skye

    Skye Registered User

    Aug 29, 2006
    17,000
    SW Scotland
    Helena, I'm sorry, but I'm not prepared to look on John's infection as anything other than a disaster.

    In a matter of a week he went from being a lovely, friendly, very fit man who unfortunately was no longer able to read, write or converse, to someone who now has to be cared for in an EMI unit.

    To me, there's only one way to see that.
     
  18. Helena

    Helena Registered User

    May 24, 2006
    715
    But when a serious infection hits that can be the result

    After all you can have a totally fit child suddenly stricken by Meningitis or Polio and they may not survive or may be permanantly damaged

    The immune system and the brain are interlinked
     

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